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Human Chorionic Gonadotropin Brand Names- Novarel | Ovidrel | Pregnyl
What is Human Chorionic Gonadotropin
Human chorionic gonadotropin (hCG) and a recombinant formulation, called choriogonadotropin alfa (r-hCG), is a gonad-stimulating polypeptide hormone normally secreted by the placenta during pregnancy.
The non-recombinant products are obtained from the urine of pregnant women.
Recombinant-hCG is produced via recombinant DNA techniques in Chinese Hamster Ovary (CHO) cells.
The pharmacological actions of hCG and of r-hCG are similar and resemble those of luteinizing hormone (LH); hCG is generally used as a substitute for LH.
HCG has been used to treat cryptorchidism or hypogonadotropic hypogonadism in males, sometimes in combination with menotropins or follitropin.
Interestingly, hCG was introduced for the treatment of cryptorchidism in 1931, and remained the only hormonal agent available to treat the condition until the 1970’s, when gonadotropin-releasing hormone (GnRH) analogs also became a treatment option.
Human chorionic gonadotropin (hCG) is used in controlled ovarian hyperstimulation protocols for infertility in females. Intralesional hCG has been utilized for the treatment of Kaposi’s sarcoma, but further clinical trials are required to prove efficacy.
Human chorionic gonadotropin is banned from use in competitive sport; some male athletes have used hCG to stimulate testosterone production or to prevent testicular atrophy resulting from the abuse of anabolic steroids and androgens.
Urine-derived hCG was first approved by the FDA in 1939, and received subsequent approval for additional indications in 1973.
Ovidrel®, the first recombinant hCG (r-hCG), received FDA approval for female infertility to induce final follicular maturation on September 20, 2000.
Ovidrel® pre-filled syringes received FDA approval in October 2003; manufacturing of Ovidrel® vials has ceased.
Indications
- cryptorchidism
- hypogonadism
- infertility
- Kaposi’s sarcoma
- oligospermia
For the treatment of male infants and children with prepubertal cryptorchidism not caused by anatomical obstruction
NOTE: HCG appears to be more effective at inducing testicular descent in those infants and children with palpable testes in the high scrotal, prescrotal, or inguinal regions.
Intra-abdominal testes are especially refractory to HCG treatment. While hormonal therapy is traditionally instituted after the age of 4 years, there are several studies that include male children of younger ages, and there is some evidence that treatment prior to age 2 years may be beneficial in terms of long-term outcomes.
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- back pain
- breakthrough bleeding
- depression
- diarrhea
- dizziness
- dyspnea
- ectopic pregnancy
- edema
- elevated hepatic enzymes
- emotional lability
- erythema
- fatigue
- flatulence
- gynecomastia
- headache
- hot flashes
- injection site reaction
- insomnia
- irritability
- leukorrhea
- malaise
- mastalgia
- nausea
- ovarian enlargement
- ovarian hyperstimulation syndrome (OHSS)
- pelvic pain
- precocious puberty
- pruritus
- rash
- restlessness
- thromboembolism
- thrombosis
- urticaria
- vaginal bleeding
- vaginitis
- vomiting
Monitoring Parameters
- pelvic exam
- pelvic ultrasound
- serum estradiol concentrations
- serum gonadotropin concentrations
- serum testosterone concentrations
- sperm count
- weight
Contraindications
- adrenal insufficiency
- ascites
- asthma
- benzyl alcohol hypersensitivity
- breast-feeding
- cardiac disease
- children
- dysfunctional uterine bleeding
- endometrial cancer
- endometriosis
- geriatric
- hamster protein hypersensitivity
- hepatic disease
- migraine
- neonates
- neoplastic disease
- obesity
- ovarian cancer
- ovarian cyst
- ovarian failure
- pituitary adenoma
- polycystic ovary syndrome
- precocious puberty
- pregnancy
- prostate cancer
- renal disease
- renal impairment
- seizure disorder
- thromboembolic disease
- thrombophlebitis
- thyroid disease
- tobacco smoking
- uterine leiomyomata
Interactions
There are no drug interactions associated with Human Chorionic Gonadotropin HCG products
